Frequently Asked Questions

PPO, Preferred Provider Organization, is a network of doctors and hospitals who have contracted with Blue Cross and Blue Shield. When you use a PPO doctor or hospital you will receive a higher benefit then if you receive care outside of the PPO network.

It's possible your doctor is already a member of the PPO network. To confirm that your doctor is a member of the Blue Cross and Blue Shield PPO network, contact your doctor or call the AT&T Customer Service Center at 1-800-621-7336 (Bargained), 1-855-439-3641 (Management). If your doctor is not a member of Blue Cross and Blue Shield PPO network, you may continue seeing that doctor but your benefits will be covered at a lower non-network level.

Blue Cross and Blue Shield has a large network of doctors, hospitals and outpatient facilities. You can ask your doctor if he or she is in the Blue Cross and Blue Shield PPO network, or you can call 1-800-621-7336 (Bargained), 1-855-439-3641 (Management) to find a provider in your area or an area where you will be traveling. You can also search the online list of Doctors and Hospitals.

Since many doctors and hospitals participate in the Blue Cross and Blue Shield PPO network, the directories are extremely large and costly. To contain costs and contribution rates, search the online list of Doctors & Hospitals. You can print a personal directory. You can also call the AT&T Customer Service Center at 1-800-621-7336 (Bargained), 1-855-439-3641 (Management) to determine if your doctor participates, or to find a participating doctor in your area. If you still want a printed directory, you may call the AT&T Customer Service Center.

Each member will receive an ID card with their name on it. You may request additional cards by logging in to Blue Access for Members, or by calling the AT&T Customer Service Center at 1-800-621-7336 (Bargained), 1-855-439-3641 (Management).

You must present your ID card to your doctor or hospital so that your provider knows who to contact for eligibility, what medical benefits are available to you under the AT&T Benefit Plan, and if precertification is required.

Benefits may be reduced for certain services if they are not authorized. You must call the Utilization and Case Management Unit prior to obtaining select services. For a list of these services check your benefit coverage.

The MSA or Utilization and Case Management is staffed with nurses who handle case management are authorized for select services. MSA needs to be notified two days prior to any elective hospitalization and within two business days after an emergency or maternity admission at the number on the back of your ID card. You may also need to contact MSA for other select services, please check your benefit coverage under your group number for which services require prenotification. The MSA is available 7 a.m. – 7 p.m. (Central Time), Monday through Friday. You may also leave a message after hours and on weekends and an MSA Advisor will call you back on the next business day.

In an emergency situation seek immediate attention. While you should always try to access care from a network facility, in some cases it is not feasible. Whether you access a network or non-network facility, contact the MSA within two business days of any emergency hospital admission. You can find the MSA number on the back of your ID card.

If you are hospitalized as the result of an emergency, you, your doctor, or a family member must notify the inpatient admission within two business days of the admission or your benefits will be reduced.

If you use a Blue Cross and Blue Shield PPO doctor or hospital, your claims will be filed electronically to Blue Cross and Blue Shield. You will not have to fill out claim forms. If you use a non-PPO doctor or hospital, you may have to pay at the time you receive the service and file a claim form for reimbursement. Claim forms are available online or by calling 1-800-621-7336 (Bargained), 1-855-439-3641 (Management).

Yes. You will receive an Explanation of Benefits (EOB) from Blue Cross and Blue Shield after your claim has been processed. The EOB will provide details of what was covered, the level of coverage, and the amount you owe, if any. You can also check your claim status through Blue Access for MembersSM.

When receiving care from network doctors and hospitals, you will not have to be concerned about being billed for charges that are considered above "usual and customary." If you receive care from a non-network doctor or hospital who charges rates above what is "usual and customary," you are responsible for the extra charges.

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